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Assessment of the association between dentate status and self-rated general health

Abstract

Objective

Aiming at preparing the basis for evidence-based dental public health policy making in Slovenia, the objective of the study was to assess the strength of association between oral health status measured by the number of missing teeth and self-rated health (SRH).

Methods

The study was designed as a pooled individual-level data study from four national cross-sectional studies carried out in the period 2001-2012, based on CINDI Health Monitor methodology. Altogether, 34,412 participants were included. A logistic regression model with poor SRH as observed outcome and the number of teeth as explanatory factor (adjusted for selected biologic, socio-economic and health factors) was proposed.

Results

In the sample, women represented 55.7% and men 44.3%, median age was 45 years. Persons with more missing teeth more likely rated their health as poor. The association was persistent even when different confounding variables were included in the model. In the group with 1-5 missing teeth, in comparison to the group with none missing teeth, OR was 1.23 (p=0.049), whereas for the group with 6-10 missing teeth, OR was 1.32 (p=0.019); for the group with >10 missing teeth, but not all, OR was 1.77 (p<0.001), and for the group with all missing teeth, OR was 2.19 (p<0.001).

Conclusions

Study results showed clear association of SRH with dentate status, which confirms the oral-general health connection. This indicates the need for the development of proper dental public health policies for better oral health, and presents a new view on the importance of preserving teeth.

Open access
The development of a consensus definition for healthcare improvement science (HIS) in seven European countries: A consensus methods approach

Abstract

Introduction

There is a limited body of research in the field of healthcare improvement science (HIS). Quality improvement and ‘change making’ should become an intrinsic part of everyone’s job, every day in all parts of the healthcare system. The lack of theoretical grounding may partly explain the minimal transfer of health research into health policy.

Methods

This article seeks to present the development of the definition for healthcare improvement science. A consensus method approach was adopted with a two-stage Delphi process, expert panel and consensus group techniques. A total of 18 participants were involved in the expert panel and consensus group, and 153 answers were analysed as a part of the Delphi survey. Participants were researchers, educators and healthcare professionals from Scotland, Slovenia, Spain, Italy, England, Poland, and Romania.

Results

A high level of consensus was achieved for the broad definition in the 2nd Delphi iteration (86%). The final definition was agreed on by the consensus group: ‘Healthcare improvement science is the generation of knowledge to cultivate change and deliver person-centred care that is safe, effective, efficient, equitable and timely. It improves patient outcomes, health system performance and population health.’

Conclusions

The process of developing a consensus definition revealed different understandings of healthcare improvement science between the participants. Having a shared consensus definition of healthcare improvement science is an important step forward, bringing about a common understanding in order to advance the professional education and practice of healthcare improvement science.

Open access
The effect of an educational intervention in family phisicians on self-rated quality of life in patients with medically unexplained symptoms

Abstract

Introduction

Medically unexplained symptoms (MUS) are very common in family medicine, despite being a poorly-defined clinical entity. This study aimed to evaluate the effect of an educational intervention (EI) on self-rated quality of life, treatment satisfaction, and the family physician-patient relationship in patients with MUS.

Methods

In a multi-centre longitudinal intervention study, which was performed between 2012 and 2014, patients were asked to rate their quality of life, assess their depression, anxiety, stress and somatisation, complete the Hypochondriasis Index, the Medical Interview Satisfaction Scale and the Patient Enablement Instrument for assessing the physician-patient relationship, before and after the EI.

Results

The mean values before and after the intervention showed that after the EI, patients with MUS gave a lower (total) mean rating of their health issues and a higher rating of their quality of life, and they also had a more positive opinion of their relationship with the physician (p<0.05). However, there were no differences in the (total) rating of treatment satisfaction before and after the EI (p=0.423). Significant differences in the symptoms in patients with MUS before and after the intervention were confirmed for stress, somatisation and hypochondriasis (p<0.05).

Conclusions

It could be beneficial to equip family physicians with the knowledge, skills and tools to reduce hypochondriasis and somatisation in MUS patients, which would improve patients’ self-rated health status.

Open access
Evaluation of national food and nutrition policy in Albania

Abstract

Introduction

The paper aims to describe the progress that has been made in the implementation of the Albanian food and nutrition policy since 2003, so as to consider its impacts to date, and to identify strategic priorities/critical areas and priorities for Albania’s future policy on improving the national food and nutrition situation.

Methods

In 2011-2012, an expert group applied an intersectoral participatory approach to evaluate the implementation of Food and Nutrition Action Plan 2003-08 in Albania. The experts employed the quantitative method, using a 9 question logical assessment matrix to measure the achievements of the individual goals of the Plan, and a qualitative tool for the interview of an interdisciplinary sample of 68-key informants-persons operating in public health nutrition, food safety and food availability related subfields, from a wide range of pertinent institutions and stakeholders.

Results

The quantitative and qualitative assessment revealed that the implementation process has faced serious barriers linked to the design of the plan, which did not accurately anticipate a theoretical framework, or structured methods for its implementation. Other impeding factors included the lack of institutional/infrastructure support, lack of intersectoral coordination and motivation, as well as insufficient capacities and know-how. Intersectoral response to the multifaceted nature of double burden of malnutrition is of key importance to improve nutritional wellbeing and health outcomes in Albania.

Conclusions

Participatory approaches that involve all relevant sectors and actors in the development, monitoring and evaluation of the implementation of public health policies based on comprehensive action-oriented assessments are promising and should be further supported.

Open access
The history of public health use of fluorides in caries prevention

Abstract

Aim

The aim of our study was to chronologically analyse various public health measures of fluoride use in caries prevention.

Methods

We systematically searched the PubMed database on the preventive role of fluorides in public health, published from 1984 to 2014. The search process was divided into four steps, where inclusion and exclusion criteria were defined. Qualitative methodology was used for the article analysis. In the research process, the described forms of F use, diversity of the described F agents, and the observed population group were analysed.

Results

In our systematic review, 40 relevant reviews were revealed. Fluorides have been used in many different forms, but only a few studies showed their significant role in public health. Water fluoridation was the most important public health measure. In the recent decades, the number of studies on topical fluorides is constantly rising. The most extensively described topical forms of fluorides are professionally applied fluoride agents and fluoride toothpaste for home-use. The use of fluoride containing toothpaste in caries prevention is a safe and successful public health measure (PHM) if their use is widespread, and it is recommended for all. The results on other topical forms of fluorides are insufficient to be suggested as an important PHM.

Conclusions

The role of fluorides in public health prevention has changed in accordance with the knowledge about the fluoride cariostatic mechanism. Previously the most important pre-eruptive effect of fluorides was supplemented by the post eruptive effect. Abundant evidence exists to show the effectiveness of systemic and topical fluorides.

Open access
Longevity in Slovenia: Past and potential gains in life expectancy by age and causes of death

Abstract

Introduction

In Slovenia, longevity is increasing rapidly. From 1997 to 2014, life expectancy at birth increased by 7 and 5 years for men and women, respectively. This paper explores how this gain in life expectancy at birth can be attributed to reduced mortality from five major groups of causes of death by 5-year age groups. It also estimates potential future gains in life expectancy at birth.

Methods

The importance of the five major causes of death was analysed by cause-elimination life tables. The total elimination of individual causes of death and a partial hypothetical adjustment of mortality to Spanish levels were analysed, along with age and cause decomposition (Pollard).

Results

During the 1997–2014 period, the increase in life expectancy at birth was due to lower mortality from circulatory diseases (ages above 60, both genders), as well as from lower mortality from neoplasms (ages above 50 years) and external causes (between 20 and 50 years) for men. However, considering the potential future gains in life expectancy at birth, by far the strongest effect can be attributed to lower mortality due to circulatory diseases for both genders. If Spanish mortality rates were reached, life expectancy at birth would increase by more than 2 years, again mainly because of lower mortality from circulatory diseases in very old ages.

Discussion and conclusions

Life expectancy analyses can improve evidence-based decision-making and allocation of resources among different prevention programmes and measures for more effective disease management that can also reduce the economic burden of chronic diseases.

Open access
The profiling of university of Ljubljana students according to their motives for exercise participation

Abstract

Introduction

The main research objective is the analysis of the grouping of the students of the University of Ljubljana, with respect to the intensity of different types of exercise participation motives, their gender, discipline and year of study, level of physical activity, status of physical education class, organization of physical activities during study, and place of residence.

Methods

Data were collected using personal data sheets during enrolling students at the University of Ljubljana. Students completed The Exercise Motivations Inventory (EMI-2), with additional data about sociodemographic parameters.

Results

The results reveal that the students could be grouped in three distinctive clusters, which can be very clearly explained in terms of the prevalence of exercise participation motives in general. The students grouped in the first cluster have the lowest average values (means) in all exercise participation motives. The students grouped in the second cluster have the profile with moderate means in all exercise participation motives, while the students grouped in the third cluster have the profile with the highest means in all exercise participation motives.

Conclusions

The results indicate overall higher motivation for physical activity in men. All the sub-samples are different in their relevant features used in clustering (e.g., male students are dominant in life sciences, etc.), which provide a guide both for the explanation of the results obtained and for practical implications.

Open access
The risk of developing a contact allergy to materials present in diving suits and diving equipment

Abstract

Allergic contact eczema is the most common occupational skin disease caused by allergens. Thus far, no research has been conducted in Poland in relation to the development of contact allergies amongst divers resulting from particular diving suit components. A group of 86 divers were examined using allergy patch tests. Standard products of contact allergy diagnostics were used containing 40 allergens.

Open access
The risk of hydrogen explosion in a submarine p. IV The implementation of high risk projects

Abstract

This series of articles on high risk projects looks at the example of the modernisation of hydrogen incinerators on a submarine. The article describes problems connected with the management of such a project.

Open access
The sugar level in divers’ blood in hyperbaric conditions

Abstract

The authors examined 104 divers performing dives in water, 14 exposed to simulated conditions in decompression chambers and 11 control subjects. The average blood sugar reading before diving amounted to 100 mg% with readings of 101 mg% after diving, whereas in the control group these readings were 107 and 100 mg% respectively and in the group of simulated dives, 102 before and 106 mg% after the exposure. It was found that the diet applied ensured a sufficiently high level blood sugar level in the subjects to protect them against hypoglycaemia. Further research in decompression chambers is required.

Open access